Imaging of Clinical Pain

A. Vania Apkarian, PhD

Professor
Department of Physiology
Feinberg School of Medicine
Northwestern University
Chicago, IL

Chronic pain has been defined as pain that persists longer than 3-6 months, and/or after resolution of the initial injury. This definition, however, is based on fairly arbitrary clinical parameters and significant efforts are being made to understand better the transition from acute to chronic pain. In this regard, brain markers for chronic pain may help to define chronicity, distinguishing it both anatomically and physiologically from acute pain. It has been observed, for example, that brain regions mapping chronic pain do not overlap with those activated in acute pain. This physiologic phenomenon, known as “double-dissociation,” complements anatomic evidence of neural reorganization. Newly remodeled pathways of chronic pain perception have been identified in the primary limbic and paralimbic regions of the brain, reflecting a shift from sensory to emotional representation as pain persists. Here, Dr. Apkarian summarizes his talk at the 2010 13th World Congress on Pain on the potential use of pain biomarkers as diagnostic tools and potentially new targets for therapy.

References

Apkarian AV, Baliki MN, Geha PY. Towards a theory of chronic pain. Prog Neurobiol. 2009;87:81-97.
Seminowicz DA, Davis KD. Pain enhances functional connectivity of a brain network evoked by performance of a cognitive task. J. Neurophysiol. 2007;97:3651-3659.
Gracely RH, Petzke F, Wolf JM, Clauw DJ. Functional magnetic resonance imaging evidence of augmented pain processing in ﬁbromyalgia. Arthritis Rheum. 2002;46:1333-1343

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